[In situ repair of parastomal hernia with Sublay methods in 34 cases].

Objective: To summarize the therapeutic method and effectiveness of parastomal hernia repair in situ with sublay methods.

Methods: Between February 2003 and May 2009, 34 patients with parastomal hernia were treated with Sublay methods using primary midline incision approach and polypropylene patch. There were 23 males and 11 females with an average age of 58.4 years (range, 43-78 years). The disease duration was 1 to 17 years (mean, 4.7 years). Of 34 patients, 6 had recurrent parastomal hernia. The diameter of hernia ring was 5-12 cm (mean, 7.2 cm).

Results: Sublay technique repair was successfully performed in all patients. The operative time was 96-160 minutes (mean, 116 minutes). The gastric tube was pulled out 12 hours to 5 days (mean, 3 days) after operation. The drainage tube was taken out at 2-7 days (mean, 4 days) after operation. The postoperative hospitalization time was 7 to 15 days (mean, 9 days). And the incisions of 32 patients healed by first intention. Incisional fat liquefaction occurred in 1 case and infection in 1 case, and their incisions healed after dressing change. Seroma at the upper of the patch occurred in 7 patients and was cured by 2 to 3 times of percutaneous puncture and local pressure. Thirty-two patients were followed up 6-75 months (mean, 32 months). No chronic pain, lumping sensation, or local expansion in wound area occurred. Two recurrences occurred 3 months and 7 months after operation, respectively, and patients restored after expectant treatment or re-operation.

Conclusion: The in situ Sublay methods using primary midline incision approach and nonabsorbable patch is a feasible and safe method for parastomal hernia repair.